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11 week old lost weight

Right some back ground.
She was born 6lbs 6oz, she was slowly gaining weight. Then she went to the hospital as the doctor wasn't happy, he thought she should be gaining faster.
Then I had to do top ups she was still (even with top ups) was gaining slowly and about three weeks ago she started refusing bottles.
She's constantly on the breast, I'm always making breast milk but she's lost weight now she's stopped gaining
What is going on?

Re: 11 week old lost weight

There are 4 main reasons a baby does not gain well. In no particular order:

Baby does not nurse often enough
Baby has difficulty extracting milk
Mother has low production
Baby has an illness or health condition that prevents adequate weight gain.

Some questions-
Have you seen an IBCLC about this?
can you give a weight check history noting when supplements were given and how much per day?
When you pump, about how much milk do you make per pumping session?
What about length and head growth-normal? Development?
Does baby ever seem content during nursing sessions or just after them?
How often does baby nurse in 24 hours and was it more or less earlier on
How much does baby poop now and was it more or less earlier on
Are you cue feeding or sceduling feeds
Does baby get a pacifier
is nursing comfortable for you

Re: 11 week old lost weight

Nursing is comfortable. No pacifier. Baby poops once every two days and has three to four wet nappies a day. Baby feeds every 2 to 3 hours, it's always been like this, for about 30-45 minutes. Baby does seem content. They haven't measured her growth. My pump gets about 20mls out each session which is after she feeds.
Born 04/01/13 at 6lbs 6oz
07/01/13 she was 5lbs 13oz - no formula top ups
09/01/13 5lbs 14.5oz - no formula top ups
13/01/13 5lbs 13oz - no formula
15/01/13 5lbs 14oz - 40ml top ups
16/01/13 5lbs 15oz - 40ml top ups
17/01/13 5lbs 14oz - 40ml top ups
Had to go to the hospital and increase top ups to 60 ml
18/01/13 6lbs 2oz - 60ml top ups
23/01/13 6lbs 5oz - 60ml top ups
29/01/13 6lbs 11oz - 60ml top ups after 75% of feeds
28/02/13 8lbs 2oz - she had the occasional bottle feed but no regular top ups
She started refusing any bottle feeds 3 weeks ago
Then today she was weighed 7lbs 12oz - no formula top ups
I have no idea what a IBCLC is
But has been ill for two weeks both me and baby

Re: 11 week old lost weight

An IBCLC is a board certified lactation consultant. When a breastfeeding baby is not nursing well, or not gaining well, etc. it is a good idea to figure out why rather than only throwing formula at the problem which is what is typical, unfortunately. You can look up if there are any locally here www.ilca.org if not, let me know.

So-they don't measure length or head circumference where you live? Huh.

Sorry to be picky but I really need a number per day. Telling my baby nurses every 2-3 hours could mean 9 times a day or 12 times a day, or 6 times a day if baby sleeps a longer stretch at night that you are not 'counting." It makes a difference.

So, about How many times in 24 hours does baby nurse,
how many times a day do you pump, (do/did you pump at all?) and what approximately amount of milk do you generally get when you pump
and how many times was baby given how much formula or pumped milk via bottle when baby was still taking bottle.

The problem is the weight loss/gain up until 5th day of life was pretty normal. But then, just as weight gain should have increased to about an ounce a day, weight gain basically stagnated until baby was supplemented 2 ounces-what-every feed? That is a lot of supplement.

At this point, it I cannot figure out what happened in those first weeks. Was baby really not gaining or was it scale error? And if baby really was not gaining, WHY was baby not gaining. All this should have been figured out at the time by your hcp. To understand WHY baby was not gaining.

At this point, the many weeks of supplementing may have impacted your milk production. So you may have low production now. Even if you did not then. And that would explain weight drop off. Low production cna be turned around, I would just like to know if that is really the problem.

Re: 11 week old lost weight

I also wanted to add-are you still trying to give a supplement and is baby still refusing the bottle? You could try alternatives, like cup feeding, or try offering the bottle via "paced bottle feeding" (gives baby more control)

Re: 11 week old lost weight

thank you
I nurse 9 times a day. I had the flu. i probably dont eat and drink 'normally'. i havent been able to pump as often as i would like. I have two under two.
it was 60ml formula top ups after every feed. when i went to the hospital with baby they said she wasnt gaining because i wasnt producing enough. they didnt do any investigation.

Re: 11 week old lost weight

OK so if baby was nursing 9 times a day from the start, that may have not been often enough. Newborns up to 6 or 8 weeks it is generally recommended to nurse at least 10-12 times or more per day. Nursing with this frequency helps assure baby gets enough and that mom's milk production gets off to a good start. Certainly you can now try encouraging baby to nurse more often.

online converter told me 60 mils = approximately 2 ounces. I can't think in metric so i convert. I understand you were told to supplement that much, and since your baby was not gaining and is now losing weight, supplementing may very well be warranted. I am certainly not saying not to supplement! But a normal entire feeding at this age (at the breast) is 2-4 ounces. Prior to 6 weeks or so, normal feeding would be 2-3 ounces, and in the first two weeks, as little as one ounce is normal. So if a baby is being supplemented enough that it becomes an entire feeding, every feeding, baby may nurse much, much less, or with much less active sucking and swallowing, exacerbating the milk production issues. That is why needed supplementation must be done carefully.

When a baby is getting supplements, it is important mom pump at those times (or with some correlation that works for mom) to give her body the signal to make more milk. Otherwise, milk production will suffer even more. It is also important to use the best pump you can-hospital rental grade if possible, if not, a double sided electric in excellent working order. If your pump is not the right kind for the job and you cannot get a better one, you can add hand expression to try to make up for that.

I assure you I am not trying to make you feel like you have not done enough. I understand that pumping on top of nursing and supplementing is very exhausting. Having a baby and a toddler to care for is exhausting. There is no judgment here, just biological fact. You understandably want to know what is happening, and my best answer is there may be some low milk production issues (at least at this point.) But there certainly may be other issues as well. Obviously I cannot be sure, a visit with an IBCLC would hopefully help answer that question better. If that is not possible, maybe you have a local breastfeeding help group?

I also understand you were not given the right help from the start for breastfeeding. This is all to common.

I suggest you take some steps to increase your milk production and encourage baby to nurse more often, and then pump as often as you can. Supplements can be given prior to nursing or after, there are benefits to either.

It is important to drink to thirst, dehydration will harm milk production.